Tracking The Second Storm

TRACKING THE SECOND STORM

BY GEOFFREY COWLEY WITH MARY HAGER AND MELINDA LIU

MEDICINE: THE ILLS OF GULF WAR VETERANS INVITE MANY THEORIES, BUT THE CAUSES ARE STILL UNKNOWN

AS AN ARMY PLATOON LEADER IN the Persian Gulf War, Troy Albuck thought nothing of doing 200 push-ups a day or leading his troops on eight-mile runs through the desert. But in 1992, a year after he returned home to Barrington, Ill., Albuck found his health eroding. The trouble started with spots on his shins, which soon spread to other parts of his body. Then. he says, his eves swelled shut and his lips bloated till the skin split. When his skin cleared up, his joints started to hurt. Today, at 26, Albuck feels like an arthritic codger. "I have to, like, unfold myself in the morning from how I slept," he says, "and I can't run at all. Literally a block and I'm done." Albuck's wife, Kelli, isn't feeling well, either. She complains of headaches, rashes and frequent vaginal infections. And the couple's 15-month-old son (born two months premature) has had everything from bleeding ulcers to meningitis.

From the Albucks' perspective, these aren't random aches, rashes and infections. They're aspects of a single affliction known as gulf war syndrome. Thousands of veterans have reported debilitating illnesses since returning from the Persian Gulf in 1991. Many are convinced that the war triggered their troubles by exposing them to hazardous substances, and their grievances have struck a chord in Congress. One Senate committee is now pursuing allegations that U.S. troops encountered chemical or biological weapons during the conflict. And last week a separate committee presented testimony on a potentially dangerous drug that the troops received as protection against chemical weapons. Neither inquiry is likely to lay the whole issue to rest. Mounting evidence suggests that gulf war syndrome is actually a spectrum of maladies with a range of different causes-not all war-related. But no one now denies that some vets are very sick.

When the first unusual health complaints surfaced three years ago, the Department of Veterans Affairs brushed them off as stress-related. But when angry vets turned up on Capitol Hill, evoking the specter of Vietnam and Agent Orange, the VA changed its tune. Though many gulf warriors are still bitter about the quality of care they receive, the agency has established special referral centers for them, and launched preliminary studies of the war's possible health effects.

Since illness is inevitable in a group of 700,000 people, the first question is whether gulf veterans are suffering more than their share. Nick Roberts, a 43-year-old naval reservist who developed non-Hodgkins lymphoma after returning from a six-month tour of duty, says he has documented 86 lymphomas among 3,200 fellow soldiers a rate that would surely warrant concern if scientifically confirmed. But the government's initial studies haven't found any unusual patterns of illness. The Army's Surgeon General's office has found no increase in cancer or anything else, says spokeswoman Virginia Stephanakis. And when the VA compared 5,300 gulf warriors with an equal number of vets who were stationed elsewhere at the time, the two groups had essentially the same profiles.

It's possible, of course, that the stricken vets are suffering in ways that the VA's survey simply failed to detect. If so, what is the nature of their illness? In the first published analysis of gulf war syndrome, VA researchers in Allen Park, Mich., evaluated 166 ailing vets whose complaints ranged from joint pain to bad dreams. The study found no common denominator (char-t), but the researchers are now grouping patients according to their most prominent symptoms to see if the subgroups share common war experiences. "We think we're moving in the right direction," says psychologist Bradley Axelrod, who worked on the study, "but we can't say that particular exposures are causing particular symptoms."

The potential causes are as varied as the health complaints. During the brief war, many soldiers breathed smoke from burning waste dumps and oil wells, and they encountered an array of paints, solvents and pesticides. Some doctors believe that intense exposure to any of these substances could trigger a condition called multiple chemical sensitivity (MCS), in which the body reacts violently to everyday chemicals. Navy Petty Officer Gary Zuspann takes MCS seriously. A year after returning from the gulf. Zuspann had to be carried into the private clinic he now attends in Dallas. But after spending two years in a sterile apartment, he says he's improving.

Other vets are pursuing more dramatic hypotheses. Some believe, for example, that they were exposed to chemical-or germ-war-fare agents that were dispersed into the atmosphere after allied forces bombed Iraqi storage sites. The Pentagon acknowledged last fall that monitors had detected minute traces of sarin (a nerve agent) and mustard gas (a blistering agent) in the Saudi desert during the war. Germ-war agents were never recovered from the battlefield or veterans' blood, but Sen. Donald Riegle Jr. speculates that allied bombing raids may have released germs that the United States supplied to Iraq during the 1980s.

Riegle may be onto something, but chemical and biological agents are somewhat unlikely suspects. Chemical weapons normally cause acute and unmistakable symptoms, not diffuse, chronic maladies. And while they can quickly immobilize troops within a small area, people outside those areas aren't normally affected. If chemical or biological agents were somehow dispersed throughout the war zone, you'd expect everyone present-British, American, Saudi or Iraqi-to suffer equally. But fewer than 50 of Britain's 42,000 troops have reported unusual ailments, and gulf war syndrome is largely unheard of in the gulf nations.

Did the American troops share some unique risk factor? If so, a likely candidate would be pyridostigmine bromide, a drug the Pentagon gave to 400,000 troops in an effort to protect them from chemical weapons. Because pyridostigmine bromide binds with the same brain chemical as nerve gas, it would theoretically pre-empt the poison and provide a shield for vulnerable cells. Nothing that the drug is commonly used to treat a muscle disorder, military doctors say they doubt it's harming the vets. Maj. Gen. Ronald Blanck, commanding general of the Walter Reed Army Medical Center, has testified that the army is "confident that no long-term adverse side effects will develop." But some experts fear that the regimen was toxic. The Senate Veterans Affairs Committee has found that when the military tested the drug, up to 3 percent of the recipients suffered adverse reactions. At that rate, the treatment might have sickened 12,000 soldiers.

The government has the tools to unravel these mysteries, but many veterans suspect it doesn't want to. The Rev. Barry Walker, a sick vet and outspoken advocate, complains that the VA and other agencies still aren't investigating the veterans' health problems rigorously. "Don't feed us pills and give us money," he says. "Find a cure." That's unlikely, given the range of ailments being reported. But the Defense Department, the National Institutes of Health and the National Academy of Sciences have all convened expert panels to study the problem. If nothing else, more research should help stem the epidemic of suspicion.

..MR.-

A SINGLE SYNDROME?

Researchers at the Department of Veterans Affairs recently evaluated 166 gulf war veterans with mysterious health problems. Among the vets' many complaints: